Individual
ANGEL SHELTON BEAVERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1613 OAKWOOD ST, BEDFORD, VA 24523-1213
(800) 554-5517
Mailing address
6255 BETHANY ROAD, RUSTBURG, VA 24588
(434) 258-4426
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
0001178518
VA
363LF0000X
Family Nurse Practitioner
Primary
0024171546
VA
Other
Enumeration date
03/08/2014
Last updated
01/19/2023
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